| Course | NU 672 Counseling and Psychotherapy |
|---|---|
| Unit | Unit 1 |
| Paper type | Psychotherapy modality comparison |
| Length | About 1,020 words, 6 pages |
| Format | APA 7 student paper |
| School | Herzing University |
| Program | MSN Psychiatric Mental Health Nurse Practitioner |
| Updated | October 2026 |
Free sample paper for NU 672 Unit 1
Three Approaches for One Woman With Panic Disorder: Cognitive Behavioral Therapy, Panic-Focused Psychodynamic Psychotherapy, and Acceptance and Commitment Therapy, and Why Two Were Set Aside
Student Name
Department of Nursing, Herzing University
NU 672: Counseling and Psychotherapy
Instructor Name
January 21, 2026
Three Approaches for One Woman With Panic Disorder: Cognitive Behavioral Therapy, Panic-Focused Psychodynamic Psychotherapy, and Acceptance and Commitment Therapy, and Why Two Were Set Aside
The Patient, Sketched as Far as the Choice Requires
Ms. J. is a composite 29-year-old woman, a dental hygienist, referred for panic attacks that began 14 months ago, after a first attack while driving on the interstate. She now has two to four attacks a month, each with a racing heart, breathlessness, dizziness, and a conviction that she is having a heart attack or will pass out; two emergency department visits found no cardiac cause. She has stopped driving on highways, avoids crowded stores, and carries a lorazepam tablet prescribed by the emergency department, which she has taken about twice a month. She has cut back to part-time work because the office is across a highway from her home. She tried an online relaxation course without benefit. She wants to drive to her sister's wedding in four months, three hours away, and to return to full-time work. Her primary care clinician has offered an antidepressant; she prefers to try therapy first.
Approach 1: Cognitive Behavioral Therapy
What it believes keeps the problem going: panic attacks are sustained by catastrophic misinterpretation of normal bodily sensations, such as reading a fast heartbeat as a heart attack, which increases anxiety and the sensations themselves in a spiral (Clark, 1986). Avoidance and safety behaviors, such as carrying the lorazepam or staying near exits, prevent her from learning that the feared outcome does not occur, so the fear persists.
What it would do: education about the panic cycle; identifying and testing catastrophic interpretations; interoceptive exposure, deliberately bringing on sensations such as dizziness and a racing heart through exercises like spinning or breathing through a straw, until they lose their threat; graded exposure to avoided situations, working toward highway driving; and gradual reduction of safety behaviors. Typically 12 to 16 weekly sessions with homework between them.
Evidence: cognitive behavioral therapy is the most extensively studied psychological treatment for panic disorder, and a network meta-analysis of psychological therapies found it among the most consistently supported (Pompoli et al., 2016).
Approach 2: Panic-Focused Psychodynamic Psychotherapy
What it believes keeps the problem going: panic symptoms carry unconscious meaning, often linked to conflicts about separation, anger, and autonomy, and attacks tend to occur when these conflicts are stirred. Understanding the emotional meaning of the attacks and their triggers reduces them.
What it would do: twice-weekly sessions for about 12 weeks exploring the circumstances and feelings around each attack, her relationships, and themes of separation and anger, with the therapist interpreting connections as they emerge.
Evidence: a randomized controlled trial found that panic-focused psychodynamic psychotherapy produced a higher response rate than applied relaxation training (Milrod et al., 2007). The overall evidence base is smaller than for cognitive behavioral therapy.
Approach 3: Acceptance and Commitment Therapy
What it believes keeps the problem going: the problem is less the sensations or thoughts than her struggle against them, her efforts to avoid or control anxious experience, which narrow her life. The aim is psychological flexibility: making room for uncomfortable sensations while acting on what she values (Hayes et al., 2006).
What it would do: clarifying her values, such as family and work; mindfulness and acceptance exercises; defusion from anxious thoughts; and committed action, which includes approaching avoided situations for the sake of those values.
Evidence: a growing evidence base across anxiety disorders, with fewer trials specifically in panic disorder than cognitive behavioral therapy.
The Choice and the Reasons
Cognitive behavioral therapy was chosen. Its maintenance account fits Ms. J. closely: her attacks began with bodily sensations she interpreted as cardiac, she has visited the emergency department twice for reassurance, and her avoidance and safety behaviors have spread from one highway to crowded stores. Each element of the account maps onto something observed, and each element of the treatment targets it. She has a concrete, time-limited goal, driving to the wedding in four months, which suits a structured course with measurable steps. She preferred an approach that would give her skills to practice. And the evidence base is the strongest of the three.
Panic-focused psychodynamic psychotherapy was set aside, not because it lacks evidence, but because nothing in her history so far points to separation or anger conflicts as triggers, and its twice-weekly schedule would be difficult to fit with work and the drive to the clinic. It would become a reasonable choice if she did not respond to cognitive behavioral therapy, or if themes of separation emerged; her first attack occurred the month her sister became engaged and began planning a move, which is worth watching.
Acceptance and commitment therapy was set aside as the primary approach, but its emphasis on values and willingness will be borrowed. Her goal, the wedding, is a values-based reason to tolerate exposure, and framing exposure in those terms may help her persist. The approaches overlap in practice more than their theories suggest, since all three ask her, eventually, to face what she avoids.
What Would Change the Choice
Three developments would lead to revisiting the choice: little change in panic frequency or avoidance after eight sessions despite completed homework; the emergence of clear relational triggers for attacks; or her inability to engage in exposure even with graded steps. The course will be reviewed formally at session eight, and the lorazepam, which works against exposure by preventing her from learning that the sensations pass on their own, will be discussed with her and her prescriber from the start.
Medication remains an option alongside therapy, not instead of it. If she chooses to start the antidepressant her primary care clinician offered, cognitive behavioral therapy can continue unchanged; a selective serotonin reuptake inhibitor does not interfere with exposure the way an as-needed benzodiazepine can. What matters is that the decision is hers, made with the information about each option, and that the two treatments are coordinated rather than started in parallel without either clinician knowing. The first session will record her preference and the name of her prescriber, so that coordination starts before any change is made.
References
Clark, D. M. (1986). A cognitive approach to panic. Behaviour Research and Therapy, 24(4), 461-470. https://doi.org/10.1016/0005-7967(86)90011-2
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: Model, processes and outcomes. Behaviour Research and Therapy, 44(1), 1-25. https://doi.org/10.1016/j.brat.2005.06.006
Milrod, B., Leon, A. C., Busch, F., Rudden, M., Schwalberg, M., Clarkin, J., Aronson, A., Singer, M., Turchin, W., Klass, E. T., Graf, E., Teres, J. J., & Shear, M. K. (2007). A randomized controlled clinical trial of psychoanalytic psychotherapy for panic disorder. American Journal of Psychiatry, 164(2), 265-272. https://doi.org/10.1176/ajp.2007.164.2.265
Pompoli, A., Furukawa, T. A., Imai, H., Tajika, A., Efthimiou, O., & Salanti, G. (2016). Psychological therapies for panic disorder with or without agoraphobia in adults: A network meta-analysis. Cochrane Database of Systematic Reviews, (4), Article CD011004. https://doi.org/10.1002/14651858.CD011004.pub2
The Herzing NU 672 Unit 1 instructions
Unit 1 asks you to compare psychotherapy approaches for a specific patient and choose one. Expect to sketch the patient, describe each approach's model of what maintains the problem, what treatment involves and the evidence for it, choose with reasons and say what would change your choice. Many versions ask for two or three approaches. Check whether your section names the modalities or lets you choose. Sketch the patient only as far as the choice requires. Compare approaches on the same dimensions so differences are visible. The strongest choice rests on fit between the patient's presentation and the approach's maintenance model, supported by trials, not on preference. Naming conditions for revisiting the choice shows you treat it as a hypothesis.
How this NU 672 Unit 1 example is built
The paper opens with a short patient sketch: age, work, onset of panic and current avoidance. Each approach then uses three labeled parts, which makes the comparison easy to follow. The CBT section explains catastrophic misinterpretation and how exposure and cognitive work address it. The psychodynamic section explains how panic may carry meaning tied to separation or anger and describes the trial that tested a focused version. The ACT section explains experiential avoidance and values-based action. The choice section ties CBT to specific details in her history, such as attacks that began with a racing heart she read as a heart attack. The final section names three findings that would send the decision back for review, turning the choice into a testable plan.
Where the points sit in the NU 672 Unit 1 rubric
Herzing's rubric for a modality comparison usually covers the patient description, the accuracy of each approach, use of evidence, the reasoning behind the choice, conditions for revision and writing. Accuracy is checked approach by approach, since a mischaracterized model weakens the whole comparison. Evidence points reward trials and reviews for each approach in the specific disorder, not psychotherapy in general. The choice criterion is where most marks are decided: the top band expects fit between the patient's details and the chosen approach's maintenance model. Revision conditions earn credit when they are specific and measurable. Parallel structure across approaches helps the reader. Clark's 1986 paper, Milrod's trial and Hayes's review belong in the APA 7 list.
Common NU 672 Unit 1 mistakes, and how to avoid them
Modality comparisons in Unit 1 often slip by describing each approach in textbook terms without applying it to the patient. Another frequent problem is evidence for psychotherapy in general rather than for the disorder. Students sometimes choose an approach without explaining why the others fit less well. The patient sketch runs long with details that do not bear on the choice. Approaches are compared on different dimensions, so differences are hard to see. Conditions for changing course are missing. Finally, base the choice on fit and evidence rather than familiarity, because graders reward a decision that follows from the patient's presentation and would make sense to a clinician trained in any of the three approaches.
Get a NU 672 Unit 1 example written to your instructions
Send the Unit 1 instructions and the rubric from your NU 672 classroom, and say which approaches your course has put on the table. We write a custom example with one composite patient, a theory of change stated for each candidate, fit weighed against the person, and the rejected approach argued. First custom sample free, back in 24 to 48 hours.
More NU 672 papers and PMHNP samples
- NU 672 Unit 2: Boundary and self-disclosure review
- NU 672 Unit 3: Session transcript analysis
- NU 672 Unit 4: Treatment goal hierarchy
- NU 672 Unit 5: Group therapy proposal
- NU 672 Unit 6: In-session ethical decision record
- NU 672 Unit 7: Treatment review and revision brief
- NU 672 Unit 8: Therapy episode portfolio
- NU 674 Unit 1: Service disagreement resolution record
- NU 670 Unit 1: Receptor activity brief
- NU 671 Unit 1: Annotated intake interview
- NU 673 Unit 1: Presenting problem profile
NU 672 Unit 1 questions, answered
Does the example have to name a specific modality?
In most sections yes, because the reasoning cannot be shown otherwise. Naming an approach forces you to state what it holds about persistence and what an hour under it contains, and both are gradeable. A paper written about supportive therapy in general has no theory to test the technique against, and the comparison criterion then has almost nothing to read.
Can the patient be someone from my placement?
No. Build a composite instead, drawn from features that recur rather than from one person you have sat with, and say in a line that it is composite and de-identified. Anything you saw under supervision belongs to that setting and to the agreement covering it, and a course example is not a place for it. Composites also let you choose details the comparison actually needs.
How many approaches belong in the comparison?
Two argued closely usually beats four described briefly, unless your instructions set a number. Each approach you add costs space that the fit reasoning and the rejected option need, and those two passages carry most of the credit. Where the instructions ask for a survey of several, keep the theory of change for each to a sentence and spend the room on the selection itself.
Where can I find a free NU 672 Unit 1 sample paper?
The full NU 672 Unit 1 panic disorder comparison is free on this page, three approaches weighed and the reasons for choosing CBT. A comparison for another disorder, such as PTSD or depression, can be written on request.
Is CBT the best therapy for panic disorder?
CBT has the strongest evidence base for panic disorder and fits patients whose attacks are maintained by misreading bodily sensations. This sample chooses it for that reason while noting that panic-focused psychodynamic therapy has also shown benefit in a trial.